Individual provider Active NPI

Fawad Ahmed Rashid, MD

  • Internal Medicine Physician
  • Orange Park, FL
National Provider Identifier
1497378103
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.48529 Issued in AL
Practice address
2001 Kingsley Avenue Office of Graduate Medical Educati
Orange Park, FL 32073
Phone
(904) 639-2000
Fax
(904) 639-2015
NPI assigned
May 28, 2020
Reactivated
Jun 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.48529 AL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2001 Kingsley Avenue Office of Graduate Medical Educati
Orange Park, FL 32073

Mailing address

111 East 210TH Street
Nw351
Bronx, NY 10467
Phone (189) 202-6239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626003846 AL Practitioner - Internal Medicine 1759825185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 Taylor Rd
Montgomery, AL 36117-3512
Phone (334) 277-8330

Hospital & facility affiliations

  • Baptist Medical Center South Hospital, Montgomery, AL, CCN 010023
  • Prattville Baptist Hospital Hospital, Prattville, AL, CCN 010108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.48529ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Jun 30, 2024 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Past Accepting new patients

Locations

400 Taylor Rd
Montgomery, AL 36117
Phone (334) 213-6287

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1497378103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EAST 210TH STREET",
            "address_2": "NW351",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "189-202-6239",
            "fax_number": "718-547-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVENUE OFFICE OF GRADUATE MEDICAL EDUCATI",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-639-2000",
            "fax_number": "904-639-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASHID",
        "first_name": "FAWAD",
        "middle_name": "AHMED",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "deactivation_date": "2022-01-18",
        "reactivation_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.48529",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.